Needle selection
When choosing a needle, one should consider the age and constitution of the patient as well as the location of the puncture. The international standard are sterile disposable steel needles of 3cm length (without handle) and 0.3 mm thickness. A metal spiral handle is advantageous for additional stimulation with current, otherwise plastic handles are sufficient.
Especially in French ear acupuncture, gold and silver needles are also used. There are several stitching techniques in acupuncture. The one-hand technique and the two-hand technique are to be mentioned.
In the former, the needle is held between thumb and forefinger and pierced 2-3mm deep in a flash. The needle is pushed forward into the subcutis under slight pressure and with a slight twist. Only then does one begin to stimulate by turning, lifting and lowering the needle and trigger the “De-Qi feeling” already mentioned.
The needle must not be bent or kinked in the process. This method requires much practice and skill. In the two-hand technique, the needle is held with thumb, index and middle finger.
The second hand stretches, presses, fixes or folds the skin area to be pricked. The tip of the needle touches the skin slightly at first, then it is guided into the depths with a rapid back and forth movement. In China, in order to save needles, in certain cases several points are reached with only one needle.
One goes with the needle from one acupuncture point to another without hurting the skin again. The tip of the needle must never perforate the skin at a second point. The depth of the stitches depends on the position and anatomy of the point to be treated.
Basically, the aim of the stitch depth is to achieve the “De-Qi feeling”. However, the highest commandment here is that an internal organ, nerve or blood vessel must never be injured and that the doctor must never puncture a region without knowing its anatomy. The tip of the needle should always point towards the diseased region to direct the needle feeling into it.
The puncture angle depends on the structure under the skin. The 90 degree injection angle is particularly suitable for muscle-rich regions. The oblique injection angle of approx.
45 degrees is mainly used around joint spaces. A tangential or horizontal puncture of 15-30 degrees is used where the musculature is thin or where sensitive anatomical structures are located underneath, e.g. on the skull or above the intercostal spaces. This technique is also used to reach several acupuncture points with one needle.
Depending on the type of needling, energy can be added or withdrawn from the patient. A distinction is made between toning technique – “Bu”(toning, adding, strengthening); strengthening the organism in states of deficiency and emptiness and underfunction – and sedating technique – “Xie” (sedate, drain, weaken); in acute, painful diseases, painful conditions in the locomotor system or inflammation).